Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This ...guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as
complex,
, and
among the slowly growing NTM and
among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.
There is a significant gap between the descriptions of Lean used by industry practitioners and the various bodies of academic research that have studied the theory and application of Lean. There is ...also a gap between applied research on Lean and basic research in the mathematical, physical and social sciences. As a result, Lean practice is based largely on trial‐and‐error experience while potentially valuable research results remain locked away unused in archival journals. This paper attempts to close these gaps by describing four “Lenses of Lean,” each of which aligns with a practical perspective and rests on a distinct body of conceptual research. Our hope is that this framework will provide a useful construct for Lean training and implementation and will also spur academic research that is relevant to advancing Lean practice.
Patients suffering from depression experience significant mood, anxiety, and cognitive symptoms. Currently, most antidepressants work by altering neurotransmitter activity in the brain to improve ...these symptoms. However, in the last decade, research has revealed an extensive bidirectional communication network between the gastrointestinal tract and the central nervous system, referred to as the "gut-brain axis." Advances in this field have linked psychiatric disorders to changes in the microbiome, making it a potential target for novel antidepressant treatments. The aim of this review is to analyze the current body of research assessing the effects of probiotics, on symptoms of depression in humans.
A systematic search of five databases was performed and study selection was completed using the preferred reporting items for systematic reviews and meta-analyses process.
Ten studies met criteria and were analyzed for effects on mood, anxiety, and cognition. Five studies assessed mood symptoms, seven studies assessed anxiety symptoms, and three studies assessed cognition. The majority of the studies found positive results on all measures of depressive symptoms; however, the strain of probiotic, the dosing, and duration of treatment varied widely and no studies assessed sleep.
The evidence for probiotics alleviating depressive symptoms is compelling but additional double-blind randomized control trials in clinical populations are warranted to further assess efficacy.
Ecosystem values are not well accounted for in decisions concerning natural resources. In this context, the concept of ecosystem services offers an important opportunity to develop a framework to ...underpin the wise use of biodiversity and other natural resources.
Although the merit of using ecosystem services to frame biodiversity evaluations has been documented, the classification systems employed mix processes (means) for achieving services and the services themselves (ends) within the same classification category. This limits their contribution to decisions concerning biodiversity. Ambiguity in the definitions of key terms – such as ecosystem processes, functions and services – exacerbates this situation.
After clarifying definitions and discussing the basic components of an effective typology, this paper develops a classification of ecosystem services that provides a framework for decisions in natural resource management. However, further work is still required to resolve particular issues, such as the classification of socio-cultural services.
Although science can contribute to effective decisions by clearly classifying services and describing their links to processes, final decisions concerning biodiversity and other natural resources are inevitably socio-political, and embedded within a particular cultural context.
Summary The diagnosis of multiple sclerosis is based on neurological symptoms and signs, alongside evidence of dissemination of CNS lesions in space and time. MRI is often sufficient to confirm the ...diagnosis when characteristic lesions accompany a typical clinical syndrome, but in some patients, further supportive information is obtained from cerebrospinal fluid examination and neurophysiological testing. Differentiation is important from other diseases in which demyelination is a feature (eg, neuromyelitis optica spectrum disorder and acute disseminated encephalomyelitis) and from non-demyelinating disorders such as chronic small vessel disease and other inflammatory, granulomatous, infective, metabolic, and genetic causes that can mimic multiple sclerosis. Advances in MRI and serological and genetic testing have greatly increased accuracy in distinguishing multiple sclerosis from these disorders, but misdiagnosis can occur. In this Series paper we explore the progress and challenges in the diagnosis of multiple sclerosis with reference to diagnostic criteria, important differential diagnoses, controversies and uncertainties, and future prospects.
Over the past 15 years, regulatory focus has gained prominence as a theory of self-regulatory motivation. Building from personality and social psychology research, the nomological network of ...regulatory focus spans individuals, groups, and organizations. This review provides an appraisal of regulatory focus from a multilevel perspective as it relates to organizational behavior, human resources, strategic management, and entrepreneurship. We begin with a discussion of the theoretical foundations of regulatory focus, including hierarchical motivation and regulatory fit theory. Using these foundations, we summarize empirical research on regulatory focus and provide actionable avenues for future research on regulatory focus, with particular attention paid to how individuals adjust their motivational strategies on the basis of context. We also consider regulatory focus as a collective function of teams to develop our understanding of motivational processes in the workplace.
The Gut-Brain-Axis is a bidirectional signaling pathway between the gastrointestinal (GI) tract and the brain. The hundreds of trillions of microorganisms populating the gastrointestinal tract are ...thought to modulate this connection, and have far reaching effects on the immune system, central and autonomic nervous systems, and GI functioning. These interactions Diagnostic and statistical manual of mental disorders have also been linked to various psychiatric illnesses such as depression, anxiety, substance abuse, autism spectrum disorder, and eating disorders. It is hypothesized that techniques aimed at strengthening and repopulating the gut microbiome, such as Fecal Microbiota Transplant (FMT), may be useful in the prevention and treatment of psychiatric illnesses.
A systematic search of five databases was conducted using key terms related to FMT and psychiatric illnesses. All results were then evaluated based on specific eligibility criteria.
Twenty-one studies met the eligibility criteria and were analysed for reported changes in mood and behavioural measures indicative of psychiatric wellbeing. The studies included were either entirely clinical (n = 8), preclinical with human donors (n = 9), or entirely preclinical (n = 11). All studies found a decrease in depressive and anxiety-like symptoms and behaviours resulting from the transplantation of healthy microbiota. The inverse was also found, with the transmission of depressive and anxiety-like symptoms and behaviours resulting from the transplantation of microbiota from psychiatrically ill donors to healthy recipients.
There appears to be strong evidence for the treatment and transmission of psychiatric illnesses through FMT. Further research with larger sample sizes and stronger scientific design is warranted in order to fully determine the efficacy and safety of this potential treatment. Registered on PROSPERO, IRD: CRD42019126795.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. ...This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.
Lean is a powerful management system aimed at improving efficiency and operational effectiveness. Since its emergence in the automotive industry, lean has been adapted for use in almost all ...manufacturing and service industries. And yet, most lean implementations fail to achieve their efficiency goals and many have deleterious impacts on the workforce. We trace both failures to a historical departure of lean practices from known principles of factory physics and job design. By leveraging these principles, we describe how lean practices can be designed to promote both operational efficiency and increased workforce satisfaction.
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